Patent Issued for Systems and methods for integrating data (USPTO 11238018): Express Scripts Strategic Development Inc.

2022 FEB 18 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A patent by the inventors Lequeux, Blayne S. (Dana Point, CA, US), filed on May 1, 2020, was published online on February 1, 2022, according to news reporting originating from Alexandria, Virginia, by NewsRx correspondents.

Patent number 11238018 is assigned to Express Scripts Strategic Development Inc. (St. Louis, Missouri, United States).

The following quote was obtained by the news editors from the background information supplied by the inventors: “A tremendous amount of transaction and interaction data is collected by a number of different entities. Often times, the data is overwhelming to intake, process, analyze, and/or provide meaningful output therefrom including insights.”

In addition to the background information obtained for this patent, NewsRx journalists also obtained the inventors’ summary information for this patent: “Example systems and methods for integrating data are described. In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of example embodiments. It will be evident, however, to one of ordinary skill in the art that embodiments of the invention may be practiced without these specific details.

“The methods and systems may be used to maintain records or other data on certain persons and entities. In the context of healthcare, and prescription drugs more specifically, master records may be maintained on prescribers, pharmacies, and patients. These records contain certain information about these healthcare participants including name, address, phone number, and the like.

“The records may be derived from various data sources. The data sources may have information on these healthcare participants in different forms and different spellings. In addition, some of the data provided by the data sources may be erroneous. The methods and systems may determine from among the information received what is most valuable and likely correct and promote, or highlight, this information. The promoted information may be used for display, analysis, or the like.

“In addition to maintaining the master records, the development of the master records enable insights into what would otherwise be disparate information and thereby enable accurate viewing and other utilizations of relevant prescription drug claims, medical claims, and the like.

“In some embodiments, the methods and systems enable integration of provider information, prescription claims, patient information and medical claims to identify links and relationships between individual providers, provider organizations, health plans and accountable care organizations (ACOs), provider networks, and patients. By so doing, profiling and benchmarking of therapeutic class, patient demographics, brand and generic drugs, specialty drugs and compounds, and mail versus retail channel may be performed. Utilization and cost may be identified, thereby enabling optimization of provider networks and ACOS, Medicare and Medicaid opportunities, and fraud, waste, and abuse detection.”

The claims supplied by the inventors are:

“1. A method of maintaining data records, the method comprising: deriving a plurality of data records received from a plurality of various data sources, wherein: at least one of the plurality of data records includes a plurality of data attributes, and the plurality of various data sources is deployed on various devices; developing a master data record including a plurality of verified data attributes, wherein: the plurality of verified data attributes are associated with the corresponding plurality of data attributes of the at least one of the plurality of data records; the plurality of data attributes includes a source significance that is deemed less than a source significance of the corresponding plurality of verified data attributes of the master data record, and at least one of the plurality of verified data attributes being cross-checked among a plurality of various data sources to be deemed correct and current; respectively comparing the plurality of data attributes of the at least one of the plurality of data records with the plurality of verified data attributes of the master data record to determine whether there is a difference; determining a relative level of source priority of a data source of the plurality of various data sources from which the at least one of the plurality of data records is originated from relative to a data source of the plurality of various data sources of a current state version of the master data record in accordance with source evaluation criteria; in response to a determination that there is a difference and that the relative level of source priority of the data source of the at least one of the plurality of data records is equal to or greater than the data source of the current state version of the master data record, storing the current state version of the master data record in a reference data record, and generating an updated version of the master data record based on the at least one of the plurality of data records; and in response to a determination that there is a difference and that the source significance of the data source of the at least one of the plurality of data records is less than the data source of the current state version of the master data record, storing the at least one of the plurality of data records in the reference data record.

“2. The method of claim 1, further comprising: in response to a determination that a date associated with the at least one of the plurality of data records is more current than a date associated with the master data record, storing the master data record in the reference data record and using the at least one of the plurality of data records to update the master data record.

“3. The method of claim 1, further comprising: determining that the reference data record is previously stored as comparison data, updating the current state version of the master data record based on a determination that the comparison data is already stored in the reference data record.

“4. The method of claim 3, further comprising: formatting the comparison data in accordance with a standardized format to create formatted comparison data; splitting the comparison data in accordance with a standardized field splits format; and mapping the formatted comparison data into a plurality of data fields based on the standardized field splits format to create the mapped comparison data.

“5. The method of claim 3, further comprising: comparing the at least one of the plurality of data records against a plurality of available master data records to identify matching source data and nonmatching source data among the at least one of the plurality of data records, the plurality of available master data records including the master data record; formatting the nonmatching source data in accordance with a standardized format to create formatted source data; splitting the nonmatching source data in accordance with a standardized field splits format; and mapping the formatted source data into a plurality of data fields based on the standardized field splits format to create the mapped formatted source data, wherein the mapped formatted source data includes the comparison data.

“6. The method of claim 5, wherein the standardized format includes a standardized spelling format, a standardized capitalization format, a wording appearance format, and a numbering appearance format.

“7. The method of claim 5, wherein comparing the at least one of the plurality of data records against the plurality of available master data records comprises: respectively comparing a plurality of source data identifiers with a plurality of master data record identifiers of the master data record, the master data record including the plurality of available master data records; when a source data identifier of the plurality of source data identifiers matches a master data record identifier of the plurality of master data record identifiers, identifying a source data portion associated with the source data identifier as being matching source data; when a source data identifier is missing, blank, or similar but matching at least a portion of a plurality of remaining data attributes of the source data portion matches a corresponding portion of the plurality of available master data records, identifying the source data portion as being matching source data; and when the source data portion of the source data has not otherwise been identified as being matching source data, identifying the source data portion as being nonmatching source data.

“8. The method of claim 7, wherein the source data portion is a portion of the at least one of the plurality of data records.

“9. The method of claim 7, further comprising: receiving a source data transformation to correct a portion of the source data correcting a portion of the source data with the source data transformation to create the source data portion.

“10. The method of claim 7, wherein the source data identifier and the master data record identifier includes NPI.

“11. The method of claim 7, wherein the source data identifier and the master data record identifier includes a telephone number, an address, or a telephone number and an address.

“12. The method of claim 3, further comprising: identifying a source data provider associated with the comparison data; determining whether a source data import from the source data provider has previously been performed; and when a determination is made that the source data import has previously been performed, selecting a standardized format and a standardized field splits format associated with the source data provider.

“13. The method of claim 3, further comprising: receiving a profile request for a prescriber, a pharmacy, or a patient; selecting the updated current state version of the master data record based on receipt of the profile request; and generating a user interface including at least a portion of the updated current state version of the master data record.

“14. The method of claim 4, wherein the mapped comparison data includes a name, an address, and a taxonomy code.

“15. The method of claim 1, wherein the plurality of data records includes prescription claims data, medical claims data, and governmental data.

“16. The method of claim 1, wherein the plurality of data records is received from a client.

“17. The method of claim 3, wherein the master data record is a prescriber record of a specific prescriber and the comparison data is associated with the specific prescriber, the master data record is a patient record of a specific patient and the comparison data is associated with the specific patient, or a specific pharmacy and the comparison data is associated with the specific pharmacy.”

There are additional claims. Please visit full patent to read further.

URL and more information on this patent, see: Lequeux, Blayne S. Systems and methods for integrating data. U.S. Patent Number 11238018, filed May 1, 2020, and published online on February 1, 2022. Patent URL: http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.htm&r=1&f=G&l=50&s1=11238018.PN.&OS=PN/11238018RS=PN/11238018

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